Strengthening a Palliative Approach in Long-Term Care
Individuals in long-term care (LTC) who are reaching end-of-life have unique physical, emotional, social, psychological, and spiritual needs. A palliative approach to care ensures these needs are being met in a compassionate way that enhances the quality of life, limits suffering and provides needed comfort.
This podcast explores the palliative approach to long-term care through conversations with patients, health care professionals, family members, researchers and others who want to improve how we care for people in long-term care.
Production of these podcasts has been made possible through a financial contribution from Health Canada. The views expressed herein do not necessarily represent the views of Health Canada.
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Strengthening a Palliative Approach in Long-Term Care
Stories in Motion: a conversation with Expressive Arts Practitioner Fay Wilkinson
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"Stories in Motion are a way to give the unspoken a voice. Because so often with the people I'm working with, they've not had that voice...but if we can put it into a story, if we can put it into a world where anything can happen and people can say anything, then those unspoken thoughts, feelings get transposed and transformed into something for the person who creates, and for the person who receives it."
Learn more about Stories in Motion: https://www.thecreativecocoon.com/
As a registered expressive arts practitioner, Fay Wilkinson is passionate about stories, both hers and others. Known as a storycatcher, Fay works with people who have life shortening illnesses, mental health challenges, and dementia. Their stories are co-created into a metaphorical story using traditional and digital formats, an offering known as Stories in Motion.
Learn more about the Strengthening a Palliative Approach to Long-Term Care project at: https://spaltc.ca/
Welcome to the Strengthening a Palliative Approach in Long Term Care Alliance podcast, exploring challenges and best practices and palliative care approaches for individuals in long-term care.
SPEAKER_02As a registered expressive arts practitioner, Faye Wilkinson is passionate about stories, both hers and others. Known as a story catcher, Faye works with people who have life-shortening illnesses, mental health challenges, and dementia. Their stories are co-created into a metaphorical story using traditional and digital formats, an offering known as stories in motion. Welcome to the podcast, Faye. Thank you for having me. It's so exciting to have you here. I first want to talk about what an expressive arts practitioner is and how you came to become one.
SPEAKER_01I liken it to being a nurse practitioner. As an expressive arts practitioner, I am not a therapist, just as a nurse practitioner is not a doctor. However, I have skills and I have training that supports me working in the way I do. But I always know when I'm working with someone, if they are going beyond my skill level, then I can refer them on to a therapist.
SPEAKER_02What kind of skills do you need to become an expressive arts practitioner?
SPEAKER_01You need to have a grounding in the theoretical framework of the work. You don't necessarily have to be an artist with a capital A. I'm a jack of all trades. I work with all media, not just one. So you need to have some understanding of the power of the medium that you're working with and what impact that might have so that you can select, it's like tools in a toolbox. You can select what's needed for a particular person or a particular environment that I'm working in. So theoretical framework, um, a high, high dose of curiosity and humility and and uh the willingness to serve. So, you know, some some practical skills, some theoretical skills, and then really just being human.
SPEAKER_02Where did you start out? Did you start out working in painting or sculpture or anything in particular?
SPEAKER_01No. So my my background is a corporate world. Oh. Which actually has proved useful for developing my practice just in terms of the business side of things. I worked for an organization and then I had my own consulting company for for a number of years. And I've always been interested in the kind of the therapeutic aspect of working with different art-making materials. So it's really a combination and the willingness to serve. That's always seems to be part of me. So those combinations of things brought me to expressive arts. And I didn't really know what it was. And I and I think it's it's an awful name because nobody really understands what the hell that means. Isn't well, isn't all art expressive, basically? Uh, but it's for me, it's a field of practice. So it's using uh whatever making materials fits the situation, and then being able to uh shift that modality, that mode of expression into something that will take somewhere, take someone somewhere that gives them a surprise. Because if we're just doing stuff that we know, I don't see any point in doing that. So the goal is to start where that person is at, but then to try and shift them with a different mode of expression that will give them some insight, maybe, or be a surprise.
SPEAKER_02Your company is called the Creative Cocoon. Tell me a bit about your company.
SPEAKER_01I had taken some time off. I had stopped my consulting company because I felt I wasn't making any difference. And so I decided I would take some time out and really take a look at what's happening. Where am I at? What do I want to do? What am I passionate about? And it's always been stories, right from when I was very, very small. I had started to develop a lot of mask work and studied mask work extensively with people in the UK and here as well. Um, because I was realizing just how many masks I was able to wear. So that took me on a whole journey, and I was able then to guide other people in that type of a process. And then as I was moving, um and a flyer dropped out of one of the books that I was packing, and it was a uh flyer for expressive arts program up here in Halliburton. Uh, so that was kind of maybe a bit of a clue. So I had begun the creative cocoon without really knowing quite what. I knew it was going to be mask, I knew it was going to be story, but I didn't know anything else. Uh, the expressive arts program, that post-grad program gave me a whole bunch of skills. And yeah, so then it sort of developed from there. And the metaphor of it was appealing to me because it was kind of me. You know, that process from caterpillar to butterfly is amazing. I mean, the darn thing liquefies and then has everything it needs to become something else. So I'm thinking that's a pretty nice metaphor. Very powerful.
SPEAKER_02Yes, very powerful.
SPEAKER_01And even when the butterfly emerges from the cocoon, it can't just fly off, it has to wait, and the fluids have to fill the body, and the wings need to strengthen before it can take off. So that was another metaphor for me. It's gonna take time, and I have to be patient. Yeah, not something I'm great at, but I'm working on it. I love that.
SPEAKER_02You mentioned that stories have been so important for you, and stories in motion are a big part of your work. Yes. Can you talk a bit about what they are?
SPEAKER_01They're basically a way to give the unspoken a voice. So a story in motion is a short digital story in a metaphorical world, and it's often fairy tale-like, but it doesn't have to be. And the stories are about the here and now. So it's not a memoir. I'm more interested in what is happening now, and we can put that into a metaphorical story, and so often with the people that I'm working with, they've never spoken about that, they've not had that voice. Because when they do, it's a literal conversation, and often those are hard. But if we can put it into a story, if we can put it into a world where anything can happen and people can say anything, um then those unspoken thoughts, feelings get transposed and transformed into something that is palatable for the person who creates it and the person who receives it. Now, all of the stories in motion are for the person I'm working with. If they choose not to share that with anybody, I respect that. Sometimes it is just for them. And sometimes they want to share it with with family or or others, or they allow me to share it more broadly.
SPEAKER_02Can you give me some examples of some of the stories that you've done?
SPEAKER_01The most recent ones are working with people living with dementia in long-term care right now. And I was working with one particular lady who was, I'm not sure if there's a scale around dementia, but she's pretty far along. She wouldn't recognize me from one week to the next. Um, and she would often start a sentence and then not be able to finish. And that was all fine. I assume with everyone that I work with that they can do everything until they prove otherwise. And it might change tomorrow. So working with her was a really remarkable experience. I have a process to transition into story because it's usually very hard for someone just to start once upon a time. It's almost like a game that we play that gives us the elements of the story. So the elements of her story were a troll who lived under a bridge, uh sort of a fairy and a dragon. And bit by bit we built the story together, just little pieces. And there was one part of that story where she was indicating with her hands that the troll and the dragon were actually one, but they had just lost each other. And when they found each other on the bridge, they recognized them, each other, and then became one. This is her story. And so with her hand, she would bring both her hands together and interlacing her fingers and saying, But they're one, they're one. So I'm thinking, holy cow! This is really remarkable. Um I mean, I still have goosebumps when I I think about that particular scene. So I was able to get AI to create a creature for me that was half dragon, half troll. So that was sort of one part, and then this new creature was talking to the fairy, who incidentally had a an invisible cloak. Unfortunately, she could never remember where she put it. So even though she'd like to wear it, she doesn't know where it is. So these little things are coming out as metaphor for her life. Losing pieces of herself and finding pieces of herself. Um so for me, this is almost a form of alchemy. It's it's as if we are playing with some kind of specialness um that I am enriched as the person I'm working with is enriched.
SPEAKER_02That's fascinating. Did the story end up getting shared with family or anyone? Yes.
SPEAKER_01And she allowed me to share it.
SPEAKER_02That's beautiful.
SPEAKER_01How long does it take to create a story like that? It rather depends how much I need to co-create and how much is coming from the person. They're quite short. So the longest one I've done is about seven minutes long, and they're usually between three and five minutes, somewhere in that realm. I was working with someone with Louis Body Syndrome, and he couldn't read his whole story. So I would became the narrator in the story, and then so I would read a bit, and then he would read a bit. I would read a bit. So both our voices are in that one. And if people can do their own imagery and illustration, then of course I'll use that.
SPEAKER_02It must be interesting to see the reaction of others if people share those stories with their family or their loved ones for them to maybe realize where the metaphors are. I imagine you get mixed reactions. Some people don't get it, and some people really get it.
SPEAKER_01You're absolutely right. Bang on. Many, many times they had no idea that their loved one was capable of doing anything close to what they're looking at.
SPEAKER_02Why are these stories so important?
SPEAKER_01Stories are an essential part of being human. This is an ancient, ancient people were sitting around fires since the dawn of time, and the stories helped us make sense of the world. I think they have the ability to transform perceptions, to get that love of wonder again through a story, and to have the opportunity to speak something that can't be spoken.
SPEAKER_02Yeah, that's beautiful. I love what you said about what can't be spoken. There are so many conversations, particularly when you're talking about dementia or life shortening illnesses where people find it very difficult to either speak the words or to be spoken to. Family members often are, you know, hesitant to have those conversations, right?
SPEAKER_01Most definitely. Yes. I do work with mental health group here. I run a series, six weeks per series, and each series has a theme of some sort. So we're just finishing up now a theme on belonging. So what does belonging look like to yourself first, to your uh place, but belonging in a place? What does that look like? Feel like? And then um belonging in a community. So we've been, I I taught them how to do some felt making, which is very transformative. We're creating sculptures using those elements, and we've doing quite a bit of abstract painting just to see what that looks like in terms of color or shape or a line. They are amazing. Sometimes they look at me and go, You're asking us to do what? But it's always an invitation, it's never a directive. And I say to them, if they get bored, stop and let's find something else that's exciting for you. But the aim is the same in terms of I want them to be surprised. So I want them to do something and then enjoy it and then look at it and say, Oh my, I didn't see that. Or, oh my, this is unsettling, or oh my, this feels so relaxing. So always trying to pull it into a bit of a surprise.
SPEAKER_02So those are stories unto themselves, right? Because, you know, if you've got a sculpture and the way that you've created that sculpture is telling a story maybe about how you're feeling, or yes. I love that element of surprise. And I would imagine that the stories in motion surprise people when they're done, um, you know, when they see what they've co-created with you. Do you really you find that they're like, oh, I didn't realize that's what it was going to be, right?
SPEAKER_01Yes, absolutely, yes. And sometimes they don't believe me. I see this this is this is your work. What inspires you? Picasso had lots of wise things to say, and he said, inspiration is everywhere, it just has to find you working. So that has really stayed with me. It can be just the smallest things that spark something, and then it'll pop out into something as a surprise.
SPEAKER_02Not everyone would choose, though, to work with people that have life-shortening illnesses or dementia or mental health challenges. You know, some people would choose to do that kind of story making uh with something that maybe is more cheerful or happy. How did you choose?
SPEAKER_01Or did it choose you? Um I don't think I chose it. I think it goes back to this notion of giving a voice to the unspoken, giving a space where that can happen. And we assume sometimes that these stories are going to be dark or sad, but not necessarily, especially in the format that we're using, because it may begin that way, and there's a real struggle. But there's nearly always something or someone or some special power that shifts things.
SPEAKER_02What do you think is next for you?
SPEAKER_01Well, I have got myself an ancient camper van, and I'm going to take stories in motion on the road next year to small underservic communities. There are a couple of other threads that are kind of knocking on my inside head. One is SOS, which is short-order stories. So stories that can be done very quickly, not as elaborate as a story in motion. So that's percolating, and it's going to take me somewhere. Yeah, so I think that's what's next. I'm planning anyway.
SPEAKER_02You might have to create your own story out of that.
SPEAKER_01Oh, there'll be there'll be a few.
SPEAKER_02Thank you so much, Faye, for speaking with me today. Of course. Appreciated it. Yeah, thank you.
SPEAKER_00You've been listening to the strengthening a palliative approach in long term care podcast. For more information about our project, visit spawnltc.ca